Angel Alsina1, Masatoshi Kudo2, Arndt Vogel3, Ann-Lii Cheng4, Won Young Tak5, Baek-Yeol Ryoo6, Thomas R Jeffry Evans7, Carlos López López8, Bruno Daniele9, Soamnauth Misir10, Min Ren11, Namiki Izumi12, Shukui Qin13, Richard S Finn14. 1. aTransplant and Specialty Services, Tampa General Hospital, Tampa, Florida, USA. 2. bDepartment of Medicine, Kindai University, Osaka, Japan. 3. cDepartment of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School, Hannover, Germany. 4. dDepartment of Medical Oncology, National Taiwan University Hospital, and National Taiwan University Cancer Center, Taipei, Taiwan. 5. eDepartment of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea. 6. fDepartment of Oncology, Asan Medical Center, and University of Ulsan College of Medicine, Seoul, Republic of Korea. 7. gInstitute of Cancer Sciences, Beatson West of Scotland Cancer Centre, University of Glasgow, Glasgow, United Kingdom. 8. hOncology Service, Marqués de Valdecilla University Hospital, IDIVAL, Santander, Spain. 9. iDepartment of Oncology, Azienda Ospedaliera G. Rummo, Benevento, Italy and Ospedale del Mare, Naples, Italy. 10. jFormerly of Eisai Inc., Woodcliff Lake, New Jersey, USA. 11. kEisai Inc., Woodcliff Lake, New Jersey, USA. 12. lDepartment of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Musashino, Tokyo, Japan. 13. mPLA Cancer Center, Nanjing Bayi Hospital, Nanjing, Jiangsu, China. 14. nGeffen School of Medicine, Department of Medicine, UCLA Medical Center, Santa Monica, California, USA.
Abstract
INTRODUCTION: Understanding the relationship between subsequent-line therapies and overall survival (OS) is important for maximizing OS for patients with hepatocellular carcinoma. OBJECTIVE: In this post hoc analysis, we investigated OS in lenvatinib- and sorafenib-treated patients from the REFLECT study, who then received subsequent anticancer medication during the survival follow-up period. METHODS: The follow-up period commenced at the first off-treatment visit after stopping the study medication and continued until study termination, withdrawal of consent, or death. OS and objective response rate were calculated for patients who did or did not receive poststudy anticancer medication for both treatment arms, as well as for the overall cohort. We investigated the subset of patients who responded to first-line treatment and subsequently received anticancer medication. RESULTS: The OS for patients initially randomized to first-line lenvatinib (versus first-line sorafenib) and who then received any subsequent anticancer medication was 20.8 vs. 17.0 months (hazard ratio [HR] 0.87; 95% CI 0.67-1.14). The OS for patients who initially received first-line lenvatinib (versus first-line sorafenib) and who did not receive any subsequent anticancer medication was 11.5 vs. 9.1 months (HR 0.90; 95% CI 0.75-1.09). Responders to first-line lenvatinib who received subsequent medication had a median OS of 25.7 months (95% CI 18.5-34.6); responders to first line-sorafenib who received subsequent medication had a median OS of 22.3 months (95% CI 14.6-not evaluable). CONCLUSIONS: In this post hoc analysis of all patients in the REFLECT study who received subsequent anticancer medication, OS was increased compared with patients who did not receive any subsequent anticancer medication. In a subset analysis of responders who had received subsequent anticancer medication, use of first-line lenvatinib led to a slightly longer median OS; more research is needed on the benefits of using first-line lenvatinib compared with sorafenib.
INTRODUCTION: Understanding the relationship between subsequent-line therapies and overall survival (OS) is important for maximizing OS for patients with hepatocellular carcinoma. OBJECTIVE: In this post hoc analysis, we investigated OS in lenvatinib- and sorafenib-treated patients from the REFLECT study, who then received subsequent anticancer medication during the survival follow-up period. METHODS: The follow-up period commenced at the first off-treatment visit after stopping the study medication and continued until study termination, withdrawal of consent, or death. OS and objective response rate were calculated for patients who did or did not receive poststudy anticancer medication for both treatment arms, as well as for the overall cohort. We investigated the subset of patients who responded to first-line treatment and subsequently received anticancer medication. RESULTS: The OS for patients initially randomized to first-line lenvatinib (versus first-line sorafenib) and who then received any subsequent anticancer medication was 20.8 vs. 17.0 months (hazard ratio [HR] 0.87; 95% CI 0.67-1.14). The OS for patients who initially received first-line lenvatinib (versus first-line sorafenib) and who did not receive any subsequent anticancer medication was 11.5 vs. 9.1 months (HR 0.90; 95% CI 0.75-1.09). Responders to first-line lenvatinib who received subsequent medication had a median OS of 25.7 months (95% CI 18.5-34.6); responders to first line-sorafenib who received subsequent medication had a median OS of 22.3 months (95% CI 14.6-not evaluable). CONCLUSIONS: In this post hoc analysis of all patients in the REFLECT study who received subsequent anticancer medication, OS was increased compared with patients who did not receive any subsequent anticancer medication. In a subset analysis of responders who had received subsequent anticancer medication, use of first-line lenvatinib led to a slightly longer median OS; more research is needed on the benefits of using first-line lenvatinib compared with sorafenib.
Authors: Tim Meyer; Daniel H Palmer; Ann-Lii Cheng; Julia Hocke; Arsène-Bienvenu Loembé; Chia-Jui Yen Journal: Liver Int Date: 2017-02-02 Impact factor: 5.828
Authors: Andrew X Zhu; Richard S Finn; Julien Edeline; Stephane Cattan; Sadahisa Ogasawara; Daniel Palmer; Chris Verslype; Vittorina Zagonel; Laetitia Fartoux; Arndt Vogel; Debashis Sarker; Gontran Verset; Stephen L Chan; Jennifer Knox; Bruno Daniele; Andrea L Webber; Scot W Ebbinghaus; Junshui Ma; Abby B Siegel; Ann-Lii Cheng; Masatoshi Kudo Journal: Lancet Oncol Date: 2018-06-03 Impact factor: 41.316
Authors: Josep M Llovet; Sergio Ricci; Vincenzo Mazzaferro; Philip Hilgard; Edward Gane; Jean-Frédéric Blanc; Andre Cosme de Oliveira; Armando Santoro; Jean-Luc Raoul; Alejandro Forner; Myron Schwartz; Camillo Porta; Stefan Zeuzem; Luigi Bolondi; Tim F Greten; Peter R Galle; Jean-François Seitz; Ivan Borbath; Dieter Häussinger; Tom Giannaris; Minghua Shan; Marius Moscovici; Dimitris Voliotis; Jordi Bruix Journal: N Engl J Med Date: 2008-07-24 Impact factor: 91.245
Authors: Freddie Bray; Jacques Ferlay; Isabelle Soerjomataram; Rebecca L Siegel; Lindsey A Torre; Ahmedin Jemal Journal: CA Cancer J Clin Date: 2018-09-12 Impact factor: 508.702
Authors: Sabrina Welland; Catherine Leyh; Fabian Finkelmeier; André Jefremow; Kateryna Shmanko; Maria A Gonzalez-Carmona; Arne Kandulski; Petia Jeliazkova; Jan Best; Thorben W Fründt; Angela Djanani; Maria Pangerl; Andreas Maieron; Richard Greil; Christina Fricke; Disorn Sookthai; Rainer Günther; Andreas Schmiderer; Henning Wege; Marino Venerito; Ursula Ehmer; Martina Müller; Christian P Strassburg; Arndt Weinmann; Jürgen Siebler; Oliver Waidmann; Christian M Lange; Anna Saborowski; Arndt Vogel Journal: Liver Cancer Date: 2022-01-14 Impact factor: 12.430